Open chest cardiac massage is an important technique in cardiac resuscitation. Although CPR external massage technique is an easier and more convenient method resuscitation, OCCM still has many advantages provided it is performed by medical professionals in a clinical setting.
OCCM facilitates greater cardiac output, 60% of normal compared to only 15-40 achieved by CPR. Also, in some animals with high (compared to humans) pitched rib cages such as canines, CPR must be performed on the animal's side lessening the effect of the compression on the heart. Thus this technique is especially appropriate for use by veterinary doctors. This technique is also practiced routinely by cardiologists who must stop and start the cardiac muscle during the course of an operation. Other types of medical specialists might use this technique during abdominal surgery. During such an operation cardiac arrest can occur accidently due to the presence of metabolites or anesthesia particles in the bloodstream that teach the heart and cause it to stop beating. In such a situation CPR would be quite inappropriate due to the exposed organs of the abdomen which could be damaged. Since the heart is easily accessed for massage from under the ribs or through an incision between two ribs, OCCM is the appropriate method for resuscitation.
Although OCCM is an invasive technique involving an incision it actually causes less internal damage than CPR which can cause fractured ribs, fractured sternum, cardiac contusion, ruptured liver, ruptured spleen, and lacerations of the vena cava and other vessels. OCCM also has the advantage of allowing the surgeon to temporarily suspend blood flow to the lower half of the body in order to increase oxygenated blood flow to the brain. This technique of resuscitation also allows for visual monitoring of the heart and is useful for patients with inelastic or barrel chests or after CPR has failed.
Presently, medical students receive little training and infrequent practice in OCCM. This is mainly due to the fact that training on humans is not legally or ethically feasible and the standard practice of using canines is both expensive and ethically undesirable as it involved inducing cardiac trauma in the animal. Because of these factors practice is minimal and extra or advanced practice is unlikely.
Although numerous devices have been created to instruct and practice CPR external heart massage such as "dummies" as in:
U.S. Pat. No. 3,049,811 (Reuben, Aug. 21, 1962)
U.S. Pat. No. 3,994,075 (Kohnke, Nov. 30, 1976)
U.S. Pat. No. 4,001,950 (Blumensaadt, Jan. 11, 1977)
U.S. Pat. No. 4,611,998 (Ramamurthy, Sep. 16, 1986)
and teaching aids not housed in mannequins such as:
U.S. Pat. No. 4,092,788 (Gowing, Jun. 6, 1978)
U.S. Pat. No. 4,619,617 (Rice, Oct. 28, 1986)
No such dummies or teaching aids are currently available to aid in the teaching of, or for practicing OCCM.